Pal Chandra Prakash, Gupta Surabhi, Kumar Deepak, Singh Pulkesh
Dept of Orthopaedics, Sarojini Naidu Medical College, Agra -282002, Uttar Pradesh, India.
J Orthop Case Rep. 2012 Jan-Mar;2(1):3-6.
Bone is the third most common site of metastatic disease. Treatment of metastatic tumours of proximal femur usually used to be either palliative in the form of radiotherapy and chemotherapy or a very radical in form of hemipelvectomy and hip disarticulation. Both forms of treatment were associated with dismal outcomes. Now with the technological advancement and refinement in surgeries a custom made hip prosthesis offers a much better treatment option to the surgeon and a good quality life to the patient.
We are presenting a case of metastatic adenocarcinoma of upper end of left femur with pathological fracture with a small primary in right lung treated with custom made hip prosthesis. Patient received chemotherapy for primary lesion and is doing well at 11 months of follow up.
This case is being presented on account of its unusual presentation and to give emphasis that in spite of metastatic disease, patient can be considered for limb salvage and megaprosthesis to improve his/her quality of life. This can be considered provided patient's general condition permits and if only a single solitary metastasis is present.
骨骼是转移性疾病的第三大常见部位。近端股骨转移性肿瘤的治疗过去通常要么采用放疗和化疗的姑息治疗方式,要么采用半骨盆切除术和髋关节离断术等非常激进的治疗方式。这两种治疗方式的预后都很糟糕。如今,随着手术技术的进步和完善,定制髋关节假体为外科医生提供了更好的治疗选择,也为患者带来了良好的生活质量。
我们报告一例左股骨上端转移性腺癌伴病理性骨折的病例,其原发灶较小,位于右肺,采用定制髋关节假体进行治疗。患者接受了针对原发灶的化疗,随访11个月时情况良好。
呈现该病例是因其表现不寻常,并强调尽管存在转移性疾病,但如果患者一般状况允许且仅存在单个孤立转移灶,仍可考虑进行保肢和使用大型假体以改善其生活质量。